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Hepatitis and Sex: Frequently Asked Questions

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It’s widely known that viral hepatitis can spread though consuming contaminated food or sharing dirty hypodermic needles. But the liver-destroying disease can also sometimes be spread through sexual contact. Here’s what you need to know to protect yourself.

Scientists have identified at least five types of viral hepatitis that lead to liver problems. In the U.S., the main threats are hepatitis A, hepatitis B, and hepatitis C.

Can all types be spread by sexual contact?

Hepatitis A spreads via fecal-oral contact, which can occur if there is direct oral-anal contact or contact with fingers or objects that have been in or near the anus of an infected person. If even a microscopic amount of virus-laden feces gets into the mouth, infection potentially can result.

Hepatitis B (HBV) is 50 to 100 times easier to transmit sexually than HIV ( the virus that causes AIDS). HBV has been found in vaginal secretions, saliva, and semen. Oral sex and especially anal sex, whether it occurs in a heterosexual or homosexual context, are possible ways of transmitting the virus. It is not transmitted by holding hands, hugging, or even dry kissing on the lips. The chance of transmission with deep kissing is unknown, as no infections have been definitively documented after exposure to infected saliva. Yet, since HBV has been found in saliva, the risk of transmission with deep kissing probably exists and the risk increases if one partner wears orthodontic braces or has open cuts or sores in the mouth. The likelihood of becoming infected with HBV grows with the number of sexual partners a person has. Thus, promiscuous individuals are more likely to get HBV.

Hepatitis C (HCV) is spread through contact with an infected person’s blood -- which may be present because of genital sores or cuts or menstruation.HCV has been detected with greater-than-average frequency among people who have a history of sexual promiscuity -- which can be defined as a history of a sexually transmitted disease, sex with a prostitute, more than five sexual partners per year, or a combination of these. A person who is in a long-term monogamous relationship with an HCV-infected person rarely contracts this virus. Only approximately 2% of sexual partners of HCV-infected people also test positive for HCV. However, it is important to note that this statistic is based on indirect evidence only. Therefore, whether these people became infected through a sexual act or by another route is unclear. For example, people in long-standing relationships generally care for one another in times of illness or injury. During such times, HCV may be transmitted to the spouse or partner, because the couple may not be as cautious about avoiding contact with blood.